Here's an interesting quote:
"It has become fashionable to say that where science and technology have created problems, it is only more scientific understanding and better technology that can carry us past them. The cure for bad management is more management. The cure for specialized research is more costly interdisciplinary research, just as the cure for polluted rivers is more costly nonpolluting detergents. The pooling of stores of information, the building up of a knowledge stock, the attempt to overwhelm present problems by the introduction of more science is the ultimate attempt to solve a crisis by escalation."
Thus, did developing better weapons eliminate war? Did developing better medicine eliminate disease? And at what costs?
I have never read or heard of Ivan Illich before now and I read only the section about the medical-industrial complex ("Watersheds") and the perceived problems therein, but I generally have a problem with utilitarian arguments. Utilitarianism argues that the solution to social and philosophical problems lies in that which would produce the greatest benefit to the greatest number of people. Superficially that seems appropriate, but it doesn’t take into account the suffering of minorities. For example, just because a person has an “orphan” disease that requires the specialization of medicine toward that disease to treat it, should he be made to reject the care that a westernized economic system has enabled because only a few people stand to benefit from it?
ReplyDeleteBecause in grad school I did a majority of my research on eugenics in America I can’t help but hear a eugenic argument in much of what Illich writes: “After the passage of this second watershed, medicine still claimed continued progress, as measured by the new landmarks doctors set for them-selves and then reached: both predictable discoveries and costs. For instance, a few patients survived longer with transplants of various organs. On the other hand, the total social cost exacted by medicine ceased to be measurable in conventional terms. Society can have no quantitative standards by which to add up the negative value of illusion, social control, prolonged suffering, loneliness, genetic deterioration, and frustration produced by medical treatment.” Eugenicists often favor utilitarian arguments, claiming the betterment of society at large through reduced healthcare costs for the few individuals who suffer “genetic deterioration.” What Illich fails to mention is that the only alternative to the prolongation of “suffering, loneliness (and) . . . frustration” is likely death.
I agree that the healthcare system and the medical-industrial complex are riddled with problems, essentially because I don’t believe it is beneficial to anyone that healthcare should be run like a corporation that makes its products available only to those who can afford them. I don’t agree that the problem is inherent in the pursuit of further technology, however. I believe technology and medical advancement is neutral; it’s the administration of such that may be flawed. I feel there is an a priori problem in arguing that technology begets the problems that only more technology can fix. Uncovering diseases and their causes and working toward their resolution is not the product of uncovering diseases and their causes. These things exist whether we pursue them or not. What I hear in Illich’s argument is that we should not upset the natural balance of society by attempting to cure diseases. He seems to think it is irresponsible and treacherous to attempt to cure naturally-arising disease because it will upset a naturally established balance. But nature is cruel. Are we not fortunate to live in an age of progress in which we don’t have to succumb to common preventable diseases? Would it be better for our society to let those individuals unable to survive without medical intervention die? That seems a savage and, again, passively eugenic proposition. If a majority were allowed to determine the priorities of medical spending, many minority populations, often those most in need of the medical technologies Illich seems to vilify here, would be obliterated.
I enjoyed a lot of the points Illich made in this section, especially those that revealed the powerfully imbalanced dynamic involved in the doctor/patient relationship. There is certainly the problem of disproportionate access to medical knowledge and resources of which I have personally found the internet to be an excellent and democratic corrective.
V.
ReplyDeleteNice thoughtful response. I'm still pouring through Illich myself, so expect more shortly.